Electrocardiographic patterns of Atrial Septal defects

This study was designed to evaluate the electrocardiographic features of Atrial Septal Defect to establish an association with crochetage pattern and incomplete RBBB. ASDs of Primum, Secundum and Sinus Venosus type were included in this study. From October 15, 2003 till January 15, 2004, a total of 104 consecutive patients of ASD were studied at Punjab Institute of Cardiology, Lahore. Patients were included in the study after confirmation of Atrial Septal Defect on transesophageal echocardiography. The mean age of the study population was 26.28 +/- 11.40 years. Among these 56[53.8%] patients were females and 48[46.2%] patients were males. The study population consisted of 94[90.4%] Secundum ASD patients followed by Sinus Venosus ASD 8[7.7%] patients and Primum ASD in only 2[l.9%] patients. Only 59[56.7%] patients had crochetage pattern in any of the leads while it was absent in 45[43.3%] patients p=0.470. Incomplete RBBB was present in 92[88.4%] patients. It was observed in 2[1.9%] patients in ASD Primum, 82[78.8%] patients in ASD Secundum and 8[7.7%] patients in ASD Sinus Venosus type. P=0.483. Although we did not observe a statistically significant association between crochetage pattern or incomplete RBBB and ASD but the presence of any of these two considerably increases the specificity of the ECG for the diagnosis of ASD

Radiology - bone trauma - qisas and diyat law

To assess the Role of Radiology in finalizing the medicolegal certification [living] with particular emphasis to bone trauma according to law of hurt in Pakistan. Department of Radiology, Mayo Hospital, Lahore 26-03-1995 to 8-09-1996 [26th of March 1995 to 8th of September 1996]. 168 patients of medicolegal nature refered for Radialogical assessment. The Protocol for identification of the cases was strictly observed. Request for Xrays was thoroughly scrutinized by the Radiologist on duty. Relevant Xrays were conducted observed and granted opinion. The information was collected from Police Record Medicolegal certificate, Xrays, opinion of Radiologist, treatment and operation notes. Specialized Performa was designed for this Purpose and variable were noted. Total number of cases were 168. A large percentage was of males 156 [92.85%]. Mean age in the case of males was about 32 years and in females 33 years. 131 [77.97%] of the cases were positi ve for radiological assessment [like shadows of metallic densities and fractures]. There were total 132 fractures of the various bones of the cases. Fractures due to blunt weapon were in 95 cases [71.96%] and due to fire arm in 37 [22.03%]. Maximum involved area was lower limbs 73 Fractures [55.4%] and minimum involvement was of lumbo sacral region 5 fractures [3.8%]. Types of fractures [with displacement, Comminuted and without displacement] were noted. Maximum number of fractures were with displacement 73 [55.4%] and minimum were comminuted 27 [24.45%]. Radiology is the most suited specialty for medicolegal certification. Its importance is enhanced after the implementation of Qisas and Diyat Law. Radiology center with qualified and trained staff in medicolegal work must be attached to each medicolegal center. Males are the victim in very large percentage of the cases and that to in productive age group